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Abstract：
To observe the clinical effect of botulinum toxin type A (BTA) injection into the salivary glands of the severe neurological patients with tracheotomy METHODS: Seven patients with severe neurological disorders after tracheotomy and obvious drooling symptoms were enrolled. BTA was injected into bilateral parotid glands and submandibular glands under the guidance of ultrasound. Unstimulated salivary flow rate (uSFR) and Drooling Severity and Frequency Scale (DSFS) were used to evaluate drooling before injection, 1 week, and 4 weeks after injection. We compared the extubation time, time of changing from balloon cannula to metal cannula, hospitalization time and incidence of recurrent pulmonary infection between these patients and other patients accepted conventional curation.
(1) The drooling severity scale (DSFS-S), the drooling frequency scale (DSFS-F), the drooling frequency and severity scale total score (DSFS-T) were significantly lower at 4 weeks after BTA injection compared to prior-treatment (p < .001). (2) uSFR of 1 week and 4 weeks were both statistically decreased than the untreated condition (p < .001). (3) Compared with the conventional group, the time of changing from balloon cannula to metal cannula was shortened obviously (p < .05) and incidence of recurrent pulmonary infection was clearly decreased (p < .05) after BTA treatment CONCLUSION: Ultrasound-guided BTA injection into salivary glands can effectively reduce saliva secretion. We also found that the time of changing cannula was shortened obviously and the incidence of recurrent pneumonia infection was reduced. BTA injection of salivary glands to cure drooling could advance to the clinical therapy in severe neurological patients after tracheotomy.
(1) The drooling severity scale (DSFS-S), the drooling frequency scale (DSFS-F), the drooling frequency and severity scale total score (DSFS-T) were significantly lower at 4 weeks after BTA injection compared to prior-treatment (p < .001). (2) uSFR of 1 week and 4 weeks were both statistically decreased than the untreated condition (p < .001). (3) Compared with the conventional group, the time of changing from balloon cannula to metal cannula was shortened obviously (p < .05) and incidence of recurrent pulmonary infection was clearly decreased (p < .05) after BTA treatment CONCLUSION: Ultrasound-guided BTA injection into salivary glands can effectively reduce saliva secretion. We also found that the time of changing cannula was shortened obviously and the incidence of recurrent pneumonia infection was reduced. BTA injection of salivary glands to cure drooling could advance to the clinical therapy in severe neurological patients after tracheotomy.
摘要：
目的：观察A型肉毒毒素（BTA）在重症神经气管切开患者唾液腺内注射的临床效果。在超声引导下将BTA注入双侧腮腺和颌下腺。注射前使用非刺激唾液流速（uSFR）和流口水严重程度和频率量表（DSFS）评估流口水，1周,注射后4周。我们比较了拔管时间,从球囊套管更换到金属套管的时间，这些患者与其他接受常规治疗的患者之间的住院时间和肺部感染复发的发生率。
结果：（1）流口水严重程度量表（DSFS-S），流口水频率量表(DSFS-F)，与治疗前相比,注射BTA后4周的流口水频率和严重程度量表总评分(DSFS-T)显著降低(p<.001).（2）1周和4周的uSFR均比未处理的条件有统计学降低（p<.001）。(3)与常规组比较,BTA治疗后，球囊插管改为金属插管的时间明显缩短（p<.05），肺部感染复发发生率明显降低（p<.05）。结论：超声引导下唾液腺注射BTA可有效减少唾液分泌。我们还发现更换套管的时间明显缩短，反复肺炎感染的发生率降低。BTA注射唾液腺治疗流口水可作为气管切开术后重症神经内科患者的临床治疗方法。
结果：（1）流口水严重程度量表（DSFS-S），流口水频率量表(DSFS-F)，与治疗前相比,注射BTA后4周的流口水频率和严重程度量表总评分(DSFS-T)显著降低(p<.001).（2）1周和4周的uSFR均比未处理的条件有统计学降低（p<.001）。(3)与常规组比较,BTA治疗后，球囊插管改为金属插管的时间明显缩短（p<.05），肺部感染复发发生率明显降低（p<.05）。结论：超声引导下唾液腺注射BTA可有效减少唾液分泌。我们还发现更换套管的时间明显缩短，反复肺炎感染的发生率降低。BTA注射唾液腺治疗流口水可作为气管切开术后重症神经内科患者的临床治疗方法。
